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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...

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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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Isolated hand paresis: a case series.

Karl B Alstadhaug1, Ane Sjulstad

  • 1Department of Neurology, Nordland Hospital Trust, Bodø, Tromsø, Norway ; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.

Cerebrovascular Diseases Extra
|May 21, 2013
PubMed
Summary

Isolated hand paresis strokes often stem from diverse causes. While hand function prognosis is generally good, long-term outcomes depend on the stroke

Keywords:
Cortical handHand knobHand motor cortexMonoparesisStrokeStroke mechanism

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Neuroscience

Background:

  • Hand knob infarction is a recognized stroke type, often presumed embolic with a good prognosis.
  • Limited data exists, prompting an assessment of patients in a general hospital stroke unit.

Purpose of the Study:

  • To investigate the etiology and prognosis of acute isolated hand paresis.
  • To analyze stroke subtypes and patient outcomes in a real-world clinical setting.

Main Methods:

  • Prospective identification of patients with acute isolated hand paresis admitted to a stroke unit (2007-2012).
  • Inclusion of patients with stroke in the hand motor cortex or adjacent areas.
  • Classification of stroke etiology using Trial of Org 10172 in Acute Stroke Treatment criteria.
  • Follow-up assessment of patient outcomes.

Main Results:

  • 13 patients (1.5% of ischemic strokes) were included; average age 62.9 years.
  • Admission MRC scale score averaged 3.1 (bad), improving to 4.6 (fair-good) at follow-up (mean 29.8 months).
  • Good to excellent outcome in 77% of patients; 15% mortality.
  • Common etiologies included small artery (77%) and large artery (85%) disease; 4 cases of undetermined etiology.
  • 3 patients had atrial fibrillation, with cardioembolism as the mechanism in 2.

Conclusions:

  • Strokes causing isolated hand paresis have heterogeneous etiologies.
  • Hand function prognosis is favorable.
  • Long-term outcomes are influenced by stroke cause and secondary prevention strategies.